The construction logic of Chinas Long-Term Care Insurance System from a Multi-Stream Perspective

Corresponding author: yaolan, lanyao@mails. tjmu. edu. cn

DOI: 10.12201/bmr.202602.00095

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  Abstract: The establishment of a long-term care insurance system is a crucial strategic initiative for China to actively respond to population aging and improve the social security system. The construction of Chinas LTCI system can be divided into three main stages: local autonomous exploration, central authorized pilots, and nationwide unified establishment. This article establishes an analytical framework based on the multiple streams framework and the development of Chinas LTCI policy. it is found that the evolution of the LTCI system at each stage is the result of the coupling of multiple factors. Specifically, the crisis in care for the disabled elderly, the crowding out of medical resources serve as the problem stream. Actively responding to population aging and the strategy of the silver haired economy, and the centralized management of LTCI by the National Healthcare Security Administration serves as the political stream. Local pilots and cross-departmental policy linkages serve as the policy stream. The coupling of these three streams drives the construction and evolution of the LTCI system.

  Key words: Long-term Care Insurance；Multiple Streams Framework； Institutional Construction；Driving Mechanism

  Submit time: 25 February 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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